Clinical odontology and diagnostics
Theme group leader
Göran Dahllöf, Professor, Division of Pedodontics
Clinical therapy research on longitudinal clinical studies and register based studies
The main subject of the theme group clinical odontology and diagnostics is clinical therapy research. It focuses on longitudinal clinical studies and register based studies. Particularly in areas were the Swedish agency for health technology assessment and assessment of social services (SBU) has identified gaps of knowledge. Research is conducted in close collaboration with departments at KI, at Karolinska University Hospital, Stockholm County, particularly the Public Dental Service and Uppsala University. In addition to the department of Dental Medicine the research is conducted within three different centers: Stockholm Craniofacial Team (SCT), Academic Center for Geriatric Dentistry (ACT) and Academic Center for Pediatric Dentistry (ABC).
The group has 7 principal investigators leading the research. Dentistry in Sweden is focused on prevention and oral health in an international perspective is excellent. Among the remaining challenges is the unequal distribution of oral diseases in socially disadvantaged groups. Projects include preventive projects in preschool children using fluoride based programs, health coaches. Improving access to oral health care and projects focusing on ways to improve oral health in drug users is also a part of this theme. The safety of using fluoride in prevention of dental caries needs high quality research. Using national registers we have shown no increase in hip fracture prevalence and no other suggested side effects are studies.
Research at SCT focuses on clinical and experiemntal research in children with cleft, lip and palate. They are a member of the Scandcleft network. Also genotype/phenotype studies in van der Woude syndrome is underway. The group also has interest in rare disorders and how malocclusions affect quality of life, psychological determinants of orthodontic treatment need and demand and osteogenesis imperfecta.
Research at ACT involves the complex interrelations between oral and general health and quality of life and has a multi-disciplinary approach on oral health and diseases as part of the ageing process. Knowledge translation and implementation are important elements in ACT’s activities as well as ethical aspects. This includes scientific knowledge, socioeconomic and health care structures, to understand critical factors, health status and related treatments that influence the oral health of older people.
Research at ABC includes prevention projects, use cognitive behavioral therapy for dental anxiety aiming at developing an internet-based CBT for dental anxiety, safety learning projects to prevent development of dental anxiety and use of VR in this area.
Infection, inflammation and immunology
Theme group leader
Margaret Sällberg Chen, Senior Lecturer, Division of Cariology
Elisabeth Boström, Kåre Buhlin, Margaret Chen, Per-Erik Engström, Anders Gustafsson, Margareta Hultin, Leif Jansson, Annsofi Johannsen, Björn Klinge, Tülay Yucel Lindberg, Bodil Lund, Thomas Modéer, Manuel Patarroyo, Timo Sorsa, Rachael Sugars
Oral infection/inflammation and the resulting hard and soft tissue reactions are among the most common diseases in the world
Inflammation, brings together researchers and research groups throughout the Department of Dental Medicine, with a unified commitment to study interactions between oral microbiota, the immune system, and subsequent inflammatory reactions. Members of the research theme include basic and clinical researchers, which highlights the translational nature of the studies that bridge odontology and medicine, as well as pre-clinical and clinical areas. Research focuses upon three main areas:
Mechanisms of Immune and Inflammatory Responses in Oral Tissues
Various aspects of immune and inflammatory mechanisms are currently under investigation to examine interactions between the immune response and chronic tissue inflammatory damage. For example, in chronic tissue destructive inflammations, like periodontitis, oral responses to chronic Graft versus Host Disease (GVHD) and cancer, the activation and differentiation of monocytes/macrophages, correlation of histopathological and inflammatory responses, and the interactions between the immune reaction and extracellular matrix milieu to drive inflammatory and reparative responses are being investigated. These studies lead towards the development of point of care diagnostic technologies and pharmaceutical ways to control inflammatory consequences, such as controlling proteinase effects of matrix metalloproteinases. Additional projects aim at improving host defence mechanisms against human pathogens associated with chronic infections and tumours.
Associations between oral inflammations and various systemic conditions
The links between oral inflammation and systemic conditions has gained prominence over recent years and has been led by key studies from the Department of Dental Medicine. The relationship between periodontal disease and cardiovascular disease is longstanding research line. However, studies are now proceeding within the areas of autoimmune diseases, neurological disorders and cancer. The relationship between periodontitis and diabetes, focuses on the effect of periodontal treatments on glucose levels in patients with diabetes and pre-diabetes. Studies are exploring the possibility that periodontitis and periodontal pathogens may be causative factors in the aetiology of rheumatoid arthritis, whereas other groups are exploring possible associations and common mechanisms between oral inflammations and Crohn’s disease, cancer and GVHD. With regards to neurological disorders, investigations are exploring the possible association between periodontitis and neurodegeneration, mainly with respect to Alzheimer's disease.
Therapeutic strategies to treat oral inflammation
The third area within the theme explores approaches to treat various forms of oral inflammation. One such example focuses on chemical plaque control, using medical plants traditionally used for oral health. In addition, groups are examining the different clinical and pathological staging tools of oral inflammations, like mucositis and cGVHD, with a view to developing improved diagnostics and therapeutic strategies. We are also investigating the possibility of controlling oral inflammations with various kinds of phototherapy. Antibiotic resistance is today the greatest threat to modern health care, and important studies within the theme provide knowledge regarding prescription patterns, clinical effects, ecological consequences and risk of developing antibiotic resistance due usage in dentistry.
An ongoing clinical project concerns the treatment outcome after implant therapy. The patients' satisfaction with implant treatment according to aesthetics and function is studied and correlated to biological and technical problems. Independent variables which could be regarded as significant risk factors for, or predictors of peri-implantitis will be identified.
Theme group leader
Peter Svensson, Professor, Division of Orofascial Pain and Jaw Function
Sensory and motor function in the orofacial area
This theme group studies sensory and motor function in the orofacial area. The group has two main lines of research. One focuses on basic somatosensory and motor mechanisms of the masticatory system. The knowledge acquired is directly implemented in the clinic to individuals in need of oral rehabilitation with prosthetic therapy. Special interest is focused on how loss of tactile sensibility due to e.g. tooth loss and oral implant therapy, or pain influence on the indiviual’s biting and chewing capacity. Also the influence of tooth losses on cognitive function is studied.
The other line of research focuses on increasing our knowledge concerning the mechanisms behind chronic orofacial pain, emphasising jaw muscle pain and its sex differences. The research is translational, spanning from basic research via human experimental studies to clinical intervention studies. Potential biomarkers in the pathogenesis of muscle pain are of specific interest. Adopted methods include human experimental pain models, endogenous pain inhibition, quantitative sensory testing, intramuscular microdialysis, muscle microbiopsies and biochemical analyses, including genomics and proteomics.
The theme group is part of the Scandinavian Center for Orofacial Neurosciences (SCON). SCON is a brick-less center (virtual network) of leading Scandinavian groups in the field of orofacial neurosciences at Aarhus University, Denmark, Karolinska Institutet and Malmö University, Sweden. Its aim is to strengthen the research activities and impact on education and clinical treatment in oral rehabilitation for the benefits of patients and society.